MISCELLANEOUS
Pulmonary puzzle
Pulmonary puzzle
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ANSWER
From the question on page 802.
Two small opacities are seen in the nasopharynx.
Using fluoroscopy, an ENT surgeon was able to identify the presence of a nasal clip (fig 1) which was removed without difficulty, hence allowing NIV to continue. The patient had been using the device at night to keep his nasal flares patent to help alleviate snoring; he had nasally inhaled the clip with the added positive pressure of his ventilator. The presence of a foreign body either in the upper or lower respiratory tract must always be eliminated when signs of respiratory distress are observed. Assessment is particularly difficult in patients with limited communication such as those with bulbar disease of whatever cause.
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Figure 1 Nasal clip device after its removal.
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Snoring is a extremely common condition that can cause significant difficulties in relationships and home life. Despite very limited evidence, there are
Relevant Article
- Acute respiratory distress in a patient using non-invasive ventilation
- K S Bonnici, W D-C Man, and M I Polkey
Thorax 2008 63: 802.[Extract] [Full Text] [PDF]
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